Helping
USAID in its effort is an NGO called ACQUIRE – or Access, Quality and Use in
Reproductive Health. Together, they are working to prevent and repair fistula,
or V.V.F. It’s an abnormal opening or passageway between the birth canal and
one of the internal organs, including the bladder. Fistula can occur during
obstructed labor or by tears in the birth canal inflicted during female
circumcision, or Yankan gishiri’, in Hausa. Waste material seeps through the
passage, often leading an unpleasant – and embarrassing – odor. But with
surgery, the passageway can be sealed.

So
far, the two groups have helped treat over 1,300 women in Zamfara state.

It
was part of a project that included buying an operating table, medicine and other
instruments for the hospital and rehabilitation facilities. It also refurbished
two fistula hospitals including the one in Gusau.

"This
support provided from USAID," says Cromer, "is to benefit women who are among the thousands
that suffer from V.V.F. in Nigeria. The story of these women is typical of many
in Africa and in Nigeria: young mothers, who sometimes after the delivery of
their children realize that they have an obstetric fistula, often wait with
many others for months at a time in hospitals [or in their] communities,
silently suffering and at times ostracized because of this affliction. Many of
these women often do not receive treatment and may live a life of shame and
embarrassment."

In
addition to working in Zamfara state, the ACQUIRE project has also helped
refurbish two rehabilitation centers and provide five operating tables at five
V.V.F. facilities in other states in northern Nigeria.

Iyeme
Efem is a spokesman for the project.

He
says ACQUIRE is working with a Dutch doctor, Kees Waaldijk, to train local –
and even family -- doctors on fistula repairs in the states of Kano, Katsina,
Kebbi, Sokoto, and Zamfara.

Currently,
Waaldijk is training six doctors.

He’s
already trained 12 doctors who are now performing operations in clinics, two of
whom are now training others in fistula surgery.

Also
trained are 2 theater nurses and 4 VVF ward nurses.

ACQUIRE
is also working at the grass roots level to convince women to go to pre-natal
clinics for examination and delivery.

Efem says, "We
are utilizing religious leaders because they play a major role in the
community, the traditional leaders who are more custodians of the tradition of
the people, so we are utilizing these people as advocacy champions."

ACQUIRE is a USAID/Nigeria
funded project being implemented by a consortium of partners lead by Engenderhealth, an international ngo working
in the health sector of Nigeria.

It aims at improving access and
utilization of fistula prevention, repair, and reintegration services.